Emergency centers not up to job in a real crisis

By Yang Yung-nane 楊永年

Twelve patients died in a recent fire at Sinying Hospital in Greater Tainan. An important thing to notice in connection with this fire is that it made it clear that there are serious problems with current emergency evacuation procedures for patients at the hospital.

The government and the hospital must have a detailed plan in place for an evacuation. If there is no such plan, problems can easily arise and people could die.

Not long ago, National Cheng Kung University Hospital invited an expert on emergency medical radiation treatment to give a lecture. According to this expert, a large number of vehicles were urgently mobilized to carry out the emergency evacuation of 800 gravely ill patients and elderly people from local hospitals after the nuclear disaster at Japan’s Fukushima Dai-ichi nuclear power plant following the Tohoku earthquake on March 11 last year.

The result of the evacuation effort was that almost 100 patients died during the evacuation, although no immediate deaths occurred as a result of radiation. This is a clear signal that the emergency evacuation of elderly people or gravely ill patients is an issue that must be addressed head-on.

Questions to be addressed include whether there is an emergency evacuation or response mechanism catering for elderly people or gravely ill patients in place and which agency should be in charge of this mechanism.

Strictly speaking, hospitals should have the necessary emergency response plans in place and if a particular hospital is a direct victim of a disaster, the situation should be handled by other connected hospitals or through a single integration mechanism.

In theory, the handling of this kind of disaster should be directed by the Department of Health (DOH). However, judging from media reports, the evacuation and rescue efforts at Sinying Hospital were actually led by the fire department, although mobilization of emergency vehicles was restricted by a host of factors.

During the rescue effort in Tainan, the fire department experienced a problem of too few ambulances. Although more ambulances later arrived from Yunlin and Chiayi counties, it appears the current system makes it impossible, or at least difficult, for the fire department to include hospital ambulances in their mobilization efforts.

There are currently six emergency operations centers (EOC) under the DOH, and Tainan falls under the southern one, which is mainly in charge of Yunlin and Chiayi counties and Greater Tainan. In theory, the EOC should integrate medical resources throughout the Yunlin, Chiayi and Tainan region and engage in emergency medical treatment.

However, this framework is experiencing a lack of funds and shortages in manpower, and one could argue that it has no powers nor any responsibilities, and that it is unable to play the role required of it.

When a major disaster occurs, an EOC may not receive information immediately. Normally, first-hand disaster information will be made available to the national or local disaster response centers. In addition, the EOCs have poor organizational structures.

This situation makes it impossible, or at least very difficult, for the EOCs to fulfill their intended role.

Yang Yung-nane is a professor of political science and director of the Graduate Institute of Political Economy at National Cheng Kung University.